Thursday, December 12, 2019

Heparin, bleeding and PTT

Q: "Bleeding due to heparin is usually directly proportional to the level of aPTT." This statement is

A) True
B) False

Answer: B

Contrary to popular belief bleeding from heparin administration/infusion has a very poor correlation with aPTT level. In fact, the major risk factors are

  •  recent surgery
  • trauma
  • underlying malignancy
  • hepatic disease
  • other bleeding disorder
  • old age
  • female gender, and
  • underlying anemia


1. Juergens CP, Semsarian C, Keech AC, et al. Hemorrhagic complications of intravenous heparin use. Am J Cardiol 1997; 80:150.

2. Hull RD, Raskob GE, Rosenbloom D, et al. Heparin for 5 days as compared with 10 days in the initial treatment of proximal venous thrombosis. N Engl J Med 1990; 322:1260.

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